<link href="{$base_dir}css/autocomplete.css" type="text/css" rel="stylesheet"/>
<script type="text/javascript" src='{$base_dir}js/jquery.autocomplete.lhv.js'></script>
<script type="text/javascript" src='{$base_dir}js/FormValidations.js'></script>
<script type="text/javascript" src="{$base_dir}modules/dept_emer/js/AJAX_EmerReception.js"></script>
<script type="text/javascript">
{literal}
    $(document).ready(function(){        
        $('#receptionInfoDiv').accordion({
             header: "h3",
             collapsible: true                                           
        });
        $('#demographicInfoDiv').accordion({
             header: "h3",
             collapsible: true,
             active: false          /*Lazy activation*/                              
        });
        
        $('label').addClass('label');

    });
{/literal}
</script>

<div id="registrationDiv">
	<span class='formAlertMsg' id='statusMessage' style="padding-left: 5px;"></span>
    <form id="emerReceptionFrm" action="{$formAction}" method="post">
    	<input type="hidden" name="receptionIdHdn" id="receptionIdHdn" value="{$receptionId}">
		<!-- Emergency reception info -->
		{include file="emer_reception/element_emergency_info.html"}
              
		<div id='relativeDiv'>
			<table cellspacing='0' cellpadding='0' class='grid' style='width: 100%'>
				<tr>
					<td colspan='2' class='form_label' style='text-align: left;'>
						<span style="text-transform: uppercase; font-weight: bold; color: #555555;">{translate}Is the aid-giver a relative of patient?{/translate}</span>
					</td>
				</tr>
				<tr>
	            	<td class='form_label' style='width:600px'>{translate}Check on this checkbox to copy information from Aid-giver to Relative{/translate}:</td>
	            	<td class='form_input'>
	            		<input type="checkbox" id='isPtnRelativeChk'/>
	           		</td>
	            </tr>
			</table>
		</div>
		
		<!-- Patient's full demographic info -->
		{include file="emer_reception/element_demographics.html"}

		<div style="text-align: right; margin-top: 10px;">
		    <div style="display: inline-table;">
		        <span id="msgSavingStatus" style="font-style: italic;"></span>&nbsp;&nbsp;
		    </div>
		    <div id="actionButtonDiv" style="display: inline-table;">
		        <input type="submit" id="saveReceptionInfoBtn" value="{translate}Save{/translate}" style="width: 60px;" onclick="return isReadyToSubmit();">
		    </div>
		    <div id="loaderDiv" style="display: none;">
		        <img src="{$base_uri}/images/ajax-loader.gif"/>
		    </div> 
		</div>
	</form>
</div>